Her left foot shifts slightly and slides forward, toe pointed down, until it hops forward and completes a small step. The room erupts around Wilma Frazier, 22.
"Unbelievable, Wilma-weezy," shouts her mother, Betty Frazier. The daughter's right leg curls up to begin its own step and the spontaneous move provokes another whoop from her physical therapist, Nikki Rapp.
"All right!" Mrs. Rapp says as she sits on the floor in front of Ms. Frazier, who is suspended in a harness attached to a rolling platform. As Ms. Frazier, a cerebral palsy patient, slowly builds up her strength in physical therapy at Neuro-Developmental Treatment Programs, her doctor, James Carroll, is taking the early steps to prove that stem cells might someday be useful for treating brain damage such as hers.
Stem cells are a hot topic again over a virtual ban President Bush imposed on federal funding for research using embryonic stem cells and a moratorium on creation of new embryonic cell lines, which are taken from donated fertilized embryos.
After former President Reagan died of Alzheimer's disease, families and patient advocates pushed to expand research they hope will lead to growing new neurons and restoring memory and function. A poll by Results for America last month shows that three-fourths of Americans polled backed increased funding for that research.
The whole field has become so politicized that people who work with adult stem cells, such as Dr. Carroll, are sometimes perceived to be working against the embryonic stem cell movement, when that is not the case, said David Hess, the chairman of the Department of Neurology at MCG and an adult stem cell researcher.
"It's become a political hot potato," Dr. Hess said, not only because of the politics but also because of the rapid advances being made. "There's so much going on in the field right now."
And there are still a lot of misconceptions about stem cells, Dr. Carroll said. For instance, contrary to popular belief, the federal government is funding research. Dr. Carroll recently received $154,000 from the National Institutes of Health to continue his work using the adult stem cells, which can be harvested from bone marrow or sometimes the nervous system, to try to repair brain damage. Patient families also might have mistaken ideas about the potential for these cells, which can produce other cell types such as red blood cells.
"I'm afraid folks have too much faith in what stem cells can do," Dr. Carroll said. "When you think about how complicated the brain is, to think that we can really go in and regrow the brain into a functioning organism in anything more than a very small amount is not realistic. I can't envision at this point regrowing a brain that's affected by Alzheimer's disease, for example."
However, repairing small, focused areas of damage, such as those that might occur as the result of the stroke, seem more likely. Dr. Carroll is studying a chemical signal called stromal cell-derived factor-1 that appears early on when tissue is damaged.
"That is basically an attractant to cells," Dr. Carroll said. "It causes cells to move to an area." The problem might be that it is not produced long enough for sufficient amounts of the stem cells to get to the damaged site. By working with mice, Dr. Carroll and colleagues will attempt to rectify that.
"That's been our concern is that the studies thus far have not gotten what we think are sufficient numbers of cells into the area," Dr. Carroll said. "We're going to be using the SDF-1 by injection to try to promote better entry of the stem cells into the area of injury." Dr. Carroll is focusing on a specific area of the brain called the hippocampus, which is involved in memory, and he intends to test for restored function with memory tests.
Even if successful in mice, federal regulators might require testing in higher animals, such as primates, before even allowing the first trials to see if it is toxic in people.
"It's something that we're working on and have hopes for, but as far as this being used in children any time over the next few years for cerebral palsy, that's probably not going to happen," Dr. Carroll said.
Ms. Frazier isn't waiting on that. After the therapist has helped her into the harness, Ms. Frazier stands on a treadmill, slowly shuffling her feet. Mrs. Rapp sits before her, gripping Ms. Frazier's ankles, pulling her feet forward to get her used to it.
"Kids who don't walk don't have that sensation," Mrs. Rapp says. The mother looks on with a smile.
"That's more than last week, when she was just standing there," Mrs. Frazier says.
Part of the workout for the 22-year-old also includes sitting up by herself, something the family works on at home. Rather than worry about stem cells, they want Ms. Frazier to be able to do a little more for herself, to gain small pieces of mobility.
"Our goal is if something should happen to us, God forbid, if she's in a nursing home ... we want her to be able to assist the person that is going to take care of her," Mrs. Frazier said.
She already has taken the first small steps.
Reach Tom Corwin at (706) 823-3213.
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